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Substance Abuse Treatment, Prevention, and Policy
Published in: Substance Abuse Treatment, Prevention, and Policy 1/2010

Open Access 01-12-2010 | Research

Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis

Authors: Karen Milligan, Alison Niccols, Wendy Sword, Lehana Thabane, Joanna Henderson, Ainsley Smith, Jennifer Liu

Published in: Substance Abuse Treatment, Prevention, and Policy | Issue 1/2010

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Abstract

Background

The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services) have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment.

Methods

We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies) of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (d) effect size estimates.

Results

In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (d = -0.09 and 0.22, respectively).

Conclusions

Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not significantly more effective than non-integrated programs. Policy implications are discussed with specific attention to the need for funding of high quality randomized control trials and improved reporting practices.
Appendix
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Metadata
Title
Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis
Authors
Karen Milligan
Alison Niccols
Wendy Sword
Lehana Thabane
Joanna Henderson
Ainsley Smith
Jennifer Liu
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Substance Abuse Treatment, Prevention, and Policy / Issue 1/2010
Electronic ISSN: 1747-597X
DOI
https://doi.org/10.1186/1747-597X-5-21

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